Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.
University Network for the Care Sector South Holland, Leiden University Medical Center, Leiden, Netherlands.
JMIR Form Res. 2024 Sep 13;8:e57108. doi: 10.2196/57108.
The occurrence of exacerbations has major effects on the health of people with chronic obstructive pulmonary disease (COPD). Monitoring devices that measure (vital) parameters hold promise for timely identification and treatment of exacerbations. Stakeholders' perspectives on the use of monitoring devices are of importance for the successful development and implementation of a device.
This study aimed to explore the potential use and value of a wearable monitoring bracelet (MB) for patients with COPD at high risk for exacerbation. The perspectives of health care professionals as well as patients were examined, both immediately after hospitalization and over a longer period. Furthermore, potential facilitators and barriers to the use and implementation of an MB were explored.
Data for this qualitative study were collected from January to April 2023. A total of 11 participants (eg, n=6 health care professionals [HCPs], 2 patients, and 3 additional patients) participated. In total, 2 semistructured focus groups were conducted via video calls; 1 with HCPs of various professional backgrounds and 1 with patients. In addition, 3 semistructured individual interviews were held with patients. The interviews and focus groups addressed attitudes, wishes, needs, as well as factors that could either support or impede the potential MB use. Data from interviews and focus groups were coded and analyzed according to the principles of the framework method.
HCPs and patients both predominantly emphasized the importance of an MB in terms of promptly identifying exacerbations by detecting deviations from normal (vital) parameters, and subsequently alerting users. According to HCPs, this is how an MB should support the self-management of patients. Most participants did not anticipate major differences in value and use of an MB between the short-term and the long-term periods after hospitalization. Facilitators of the potential use and implementation of an MB that participants highlighted were ease of use and some form of support for patients in using an MB and interpreting the data. HCPs as well as patients expressed concerns about potential costs as a barrier to use and implementation. Another barrier that HCPs mentioned, was the prerequisite of digital literacy for patients to be able to interpret and react to the data from an MB.
HCPs and patients both recognize that an MB could be beneficial and valuable to patients with COPD at high risk for exacerbation, in the short as well as the long term. In particular, they perceived value in supporting self-management of patients with COPD. Stakeholders would be able to use the obtained insights in support of the effective implementation of MBs in COPD patient care, which can potentially improve health care and the overall well-being of patients with COPD.
加重事件的发生对慢性阻塞性肺疾病（COPD）患者的健康有重大影响。监测设备可以测量（生命）参数，有望及时识别和治疗加重事件。利益相关者对监测设备使用的看法对于设备的成功开发和实施非常重要。
本研究旨在探讨可穿戴监测手环（MB）在高加重风险 COPD 患者中的潜在使用价值。检查了卫生保健专业人员和患者的观点，包括住院后立即和长期的观点。此外，还探讨了使用和实施 MB 的潜在促进因素和障碍。
本定性研究的数据收集于 2023 年 1 月至 4 月期间。共有 11 名参与者（例如，n=6 名卫生保健专业人员[HCP]、2 名患者和 3 名额外患者）参与。共进行了 2 次通过视频电话进行的半结构式焦点小组讨论；1 次是与具有不同专业背景的 HCP 进行的，1 次是与患者进行的。此外，还与 3 名患者进行了 3 次半结构式个人访谈。访谈和焦点小组讨论了态度、愿望、需求，以及支持或阻碍潜在 MB 使用的因素。根据框架方法的原则，对访谈和焦点小组的数据进行了编码和分析。
HCP 和患者都强调了 MB 通过检测正常（生命）参数的偏差并随后提醒用户，从而及时识别加重的重要性。根据 HCP 的说法，这就是 MB 应该支持患者自我管理的方式。大多数参与者认为，MB 在住院后的短期和长期使用价值没有太大差异。参与者强调的 MB 潜在使用和实施的促进因素是易用性以及为患者提供使用 MB 和解释数据的某种形式的支持。HCP 和患者都表示对潜在成本的担忧是使用和实施的障碍。HCP 提到的另一个障碍是，患者需要具备数字素养，才能能够解释和对 MB 数据做出反应。
HCP 和患者都认为 MB 对高加重风险 COPD 患者在短期和长期内都可能是有益和有价值的。特别是，他们认为支持 COPD 患者的自我管理具有价值。利益相关者将能够利用所获得的见解来支持在 COPD 患者护理中有效实施 MB，这可能会改善医疗保健和 COPD 患者的整体幸福感。
